A significant number of children and adolescents display a behavioral disorder which suggests total disregard for the basic rights of others, far exceeding the expected idiosyncrasies of the developing individual. Children and adolescents with these conduct disorders have considerable difficulty behaving in a socially acceptable way and in following rules at school and at home. The conduct disorder patient typically exhibits aggressive behavior toward people and animals, is deceitful, lies, steals, destroys the property of others, is truant from school, runs away from home, as well as a variety of additional antisocial symptoms. When untreated, children and adolescents suffering with conduct disorders are typically very unhappy and face a difficult future. They are unable to cope with the demands of adulthood, have continuing problems maintaining relationships, are unable to hold a job, and often break the law and behave antisocially.
Current therapies for the treatment of conduct disorders are not totally satisfactory. Methylphenidate (Ritalin.TM.), which exhibits noradrenergic and dopaminergic effects, has been reported to induce improvement in many patients' symptoms (Shah, et al., Journal of Child and Adolescent Psychopharmacology, 4(4), 255-261 (1994)). Some patients, however, were refractory to methylphenidate dosing, and others were unable to be maintained on the treatment for long periods of time. Furthermore, due to the high potential for substance abuse in conduct disorder patients, the use of stimulants such as methylphenidate is problematic. Shah also demonstrated that certain patients benefitted from the augmentation of methylphenidate treatment by the addition of pemoline, a dopamine reuptake inhibitor. Haloperidol and lithium carbonate have found utility in the treatment of the aggressive symptoms of conduct disorder (Platt, et al., Arch. Gen. Psychiatry, 41, 657-662 (1984)), but both are associated with undesirable side effects, including negative effects on cognition.
The need for a safe and effective treatment for conduct disorders, without the disadvantages of current therapies, continues to be a concern of the psychiatric community.